Does Suboxone Treatment Substitute One Addiction for Another?

Suboxone, a medication for opioid use disorder (MOUD), is not a substitute addiction but a legitimate, evidence-based treatment. It contains buprenorphine, a partial opioid agonist that prevents intense euphoria and respiratory depression, and naloxone to prevent misuse. While a person can develop physical dependence, this is distinct from addiction, which is characterized by compulsive drug-seeking and loss of control. Suboxone treatment is commonly used for opioid withdrawal.

If you’re grappling with opioid use disorder, you’ve likely encountered a common question: Is Suboxone treatment simply swapping one addiction for another? This concern, though understandable, is a misconception that can prevent people from seeking the help they need. The truth is, medications for opioid use disorder (MOUD), like Suboxone, are evidence-based treatments that can pave the way for genuine drug recovery.

Read on to explore the science behind Suboxone, clarify the difference between dependence and addiction, and address common concerns to help you make informed decisions about your recovery journey.

Is Suboxone Just Trading One Addiction for Another?

No. This is a common misconception. The medical and scientific consensus is clear: Suboxone is a legitimate treatment, not a substitute addiction. It’s crucial to understand how Suboxone works to see why.

Suboxone contains two key ingredients: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist. Unlike full opioid agonists like heroin or fentanyl, buprenorphine only partially activates opioid receptors in the brain. This creates a “ceiling effect,” meaning that beyond a certain dose, the effects don’t increase. This prevents the intense euphoria and dangerous respiratory depression associated with opioid addiction. Naloxone is an opioid antagonist added to prevent misuse through injection.

Can You Get Addicted to Suboxone?

While you can develop physical dependence on Suboxone, it’s not the same as addiction.

How is Suboxone Dependence Different from Addiction?

Physical dependence is a physiological adaptation to a medication. If you stop taking Suboxone abruptly, you may experience opioid withdrawal symptoms. This is because your body has adjusted to the presence of the medication. Many medications, like antidepressants or blood pressure pills, can cause physical dependence.

Addiction, on the other hand, is a chronic brain disorder characterized by compulsive drug-seeking and use despite negative consequences. It involves changes in the brain’s reward, motivation, and executive function systems. Addiction is about loss of control and compulsive behavior.

The key difference is that someone taking Suboxone as prescribed is not compulsively seeking the drug. They’re following a medical plan to manage cravings and withdrawal, and to stabilize their brain chemistry.

Why Do People Say Suboxone is a Replacement Drug?

This misconception often stems from a misunderstanding of how medication-assisted treatment (MAT) works and a stigma surrounding it. Some people believe that true recovery requires complete abstinence from all substances. However, research shows that MAT, including Suboxone, is often more effective than abstinence-only approaches.

Can I Stay on Suboxone for the Rest of My Life?

The duration of Suboxone treatment is a personal decision made in consultation with your doctor. Some people may eventually taper off Suboxone, while others benefit from long-term maintenance. The American Society of Addiction Medicine recommends that medication for opioid use disorder be provided as long as patients “benefit from it and wish to continue.”

Does Suboxone Make You Feel High?

When taken as prescribed, Suboxone should not make you feel high. Buprenorphine’s partial agonist properties and ceiling effect prevent the intense euphoria associated with full opioids. The goal of Suboxone is to stabilize brain chemistry, reduce cravings, and allow you to function normally.

What Happens if You Stop Taking Suboxone Cold Turkey?

Stopping Suboxone abruptly can lead to Suboxone detox and withdrawal symptoms, which can include nausea, muscle aches, anxiety, and insomnia. It’s essential to work with your doctor to develop a Suboxone tapering schedule under medical supervision to minimize these effects and prevent relapse.

Is Suboxone Considered “True” Sobriety?

This is a complex question with no easy answer. Some people in recovery view sobriety as complete abstinence from all substances, including medications like Suboxone. Others believe that sobriety is about living a healthy and fulfilling life, regardless of whether medication is involved. Ultimately, the definition of sobriety is a personal one, and there are many paths to recovery. The opinions of others in recovery are merely opinions and are not necessarily science-backed, so always take others’ comments with a grain of salt, particularly if they are not an addiction professional. 

How Does Suboxone Block Other Opioids?

Buprenorphine has a high affinity for opioid receptors, meaning it binds to them tightly. This prevents other opioids, like heroin or fentanyl, from binding to those receptors and producing their effects. This opioid agonist effect helps to reduce cravings and prevent relapse.

What are the Long-Term Effects of Buprenorphine?

Research shows that long-term Suboxone maintenance is generally safe and effective. Studies have found that people who stay on Suboxone longer have better outcomes, including reduced opioid use, improved employment rates, and better overall quality of life.

Benefits of Long-Term Suboxone Maintenance

The benefits are numerous. Research consistently demonstrates that long-term Suboxone maintenance leads to

• Reduced opioid use and overdose risk
• Improved employment and housing stability
• Better family relationships
• Improved mental health

Managing Opioid Cravings with Buprenorphine

Buprenorphine is effective at managing opioid cravings with buprenorphine because it partially activates opioid receptors, satisfying the brain’s need for opioids without producing the intense euphoria that drives addiction.

Overcoming the Stigma of Medication-Assisted Treatment

One of the biggest challenges in addressing opioid use disorder is overcoming the stigma of medication-assisted treatment. Many people view MAT as a sign of weakness or failure, but this is simply not true. MAT is a safe and effective treatment that can help people achieve lasting recovery.

Suboxone vs. Methadone for Long-Term Recovery

Suboxone and methadone are both medications used to treat opioid use disorder, but they have some key differences. Suboxone is a partial opioid agonist, while methadone is a full opioid agonist. This means that Suboxone has a lower risk of overdose and is less likely to produce euphoria. Suboxone can be prescribed in an outpatient setting, while methadone is typically dispensed at specialized clinics.

Why Suboxone is Not a Substitute Addiction

The bottom line? Suboxone is not a substitute addiction because it is a medication taken as prescribed to treat a medical condition. It does not produce the intense euphoria or compulsive drug-seeking behavior associated with addiction.

If you or someone you know is struggling with substance abuse, Mountainside can help. We offer individualized and comprehensive treatment that meets people where they are. Speak with an admissions specialist today to discover your options!